In ulcerative colitis (UC), frequent and urgent defecation are common symptoms, but the pathogenesis of these symptoms is incompletely understood. There is often a mismatch between severity of symptoms and endoscoppically demonstrable inflammation. The role of impaired motor function is unclear and previous reports provide contradictory data. Specifically, no data is available on tonic contractile activity and compliance of the colon in UC. The incidence and prevalence of UC is higher in non-and ex-smokers as compared to current smokers. Transdermal nicotine is effective in improving symptoms in active UC.
Our aims are to study colonic compliance, phasic and tonic contractility before and after a meal and during single-blind, placebo-controlled intravenous administration nicotine in healthy subjects and UC paqtients. In a single study session, 10 healthy subjects and 28 patients with UC (14 with endoscopically inactive and 14 with endoscopically active disease) will undergo endoscopy-aided placement of a combined manometry and barostat balloon assembly with the balloon positioned in the lower descending colon. This proposal combines the expertise of the GI Neuroscience Group and the Inflammatory Bowel Disease group at Mayo Clinic. It will provide novel insights into alterations of fasting and postprandial colonic motor function in patients with active, and inactive diseases, and a more thorough understanding of the pharmacological effects of nicotine in health and UC.
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